Circumcision method and probe

ABSTRACT

Probes for use in loosening and extracting smegma from the cervix of the glans penis of an uncircumcised male human being, preliminary to a circumcision operation, are disclosed. The probe construction is characterized by a small, somewhat elongated bulbous head having an oval or rounded tip and undercut at one side to provide a hook structure adapted to be protracted interiorly of the mucosa into the cervix of the glans. The hook structure may be provided with a medial longitudinal channel to define a pair of lateral ears to enhance the smegma-loosening action. When the probe is moved to a limited extent laterally back and forth, i.e., right and left, along the corona of the glans, with the hook structure protracted into the cervix of the glans behind the corona, smegma accumulated in the cervix is loosened and broken free by the hook structure without risk of injury to the frenulum and can then be pulled out with the hook structure when the probe is withdrawn from the prepuce. This abstract is not to be taken either as a complete exposition or as a limitation of the present invention, however, the full nature and extent of the invention being discernible only by reference to and from the entire disclosure.

United States Patent [1 1 Bronstein [54] CIRCUMCISION METHOD AND PROBE[76] Inventor: Harry Bronstein, 2311 Avenue .1,

[52] US. Cl. ..128/304, 128/2 B [51] Int. Cl. ..A61b' 17/22 [58] Fieldof Search ..l28/1 R, 2 B, 269, 128/270, 303, 304; 66/118 [56] ReferencesCited UNITED STATES PATENTS 1,621,212 3/1927 Myers ..128/304 1,628,2755/1927 Robinson ..128/304 3,088,454 5/1963 Shute ....128/304 X 3,583,3906/1971 Jascalevich .....128/2 B 1,355,878 10/1920 Akin ..66/1l82,440,413 4/1948 Mock ..66/1l8 2,465,636 3/1949 Doerr ..66/118 FOREIGNPATENTS OR APPLICATIONS 971,045 6/1950 France ..l28/304 PrimaryExaminer-Aldrich F. Medbery Attorney-Norbert P. Holler 1 May 15, 1973[57] ABSTRACT Probes for use in loosening and extracting smegma from thecervix of the glans penis of an uncircumcised male human being,preliminary to a circumcision operation, are disclosed. The probeconstruction is characterized by a small, somewhat elongated bulboushead having an oval or rounded tip and undercut at one side to provide ahook structure adapted to be protracted interiorly of the mucosa intothe cervix of the glans. The hook structure may be provided with amedial longitudinal channel to define a pair of lateral ears to enhancethe smegma-loosening action. When the probe is moved to a limited extentlaterally back and forth, i.e., right and left, along the corona of theglans, with the hook structure protracted into the cervix of the glansbehind the corona, smegma accumulated in the cervix is loosened andbroken free by the hook structure without risk of injury to the frenulumand can then be pulled out with the hook structure when the probe iswithdrawn from the prepuce.

This abstract is not to be taken either as a complete exposition or as{a limitation of the present invention, however, the full nature andextent of the invention being discernible only by reference to and fromthe entire disclosure.

9 Claims, 8 Drawing Figures I CIRCUMCISION METHOD AND PROBE Thisinvention relates to the art of circumcision of male human beings, andin particular to probes designed for use in connection therewith.

Preliminary to the performance of a circumcision operation, it hasheretofore been recommended practice to pass a narrow blunt-ended probethrough the preputial orifice into the space between the glans penis andthe mucosa within the prepuce or foreskin overlying the same, for thepurpose of loosening the mucosa from I the surface of the glans in orderto enable it subsequently to be cut off together with the prepuce.Incidental to the loosening of the mucosa, some of the smegmaaccumulated on the surface of the glans is also loosened.

Smegma, apart from accumulating on the surface of the glans, alsoaccumulates in the cervix of the penis of an uncircumcised male, i.e.behind the corona of the glans, where it is not accessible for removal,however, unless the person is properly circumcised. The removal of suchsmegma is a matter of extreme importance, since medical research hasstatistically shown that smegma is carcinogenic as well as acontributing factor to the occurrence of infections, inflammations andother diseases of the penis. Accordingly, circumcision has now become amedically acceptable and highly recommended practice designed tofacilitate access to the cervix for removal of smegma and to prevent itsaccumulation there. Nevertheless, many circumcisions presently performedare deficient in that insufficient steps are taken to ensure theloosening and removability of the smegma from the cervix of the glans,as a result of which the avowed purpose of the entire operationfrequently is effectively nullified. I believe that one of the primaryreasons for this has been the inability of the circumcision probesheretofore used to loosen and break free the smegma in the cervix of theglans.

In addition to the foregoing, operators performing probing operationspreliminary to circumcisions have generally not been aware of a need forlimiting the movement of the probe over the glans in the ventraldirection. As a result, they have frequently caused severe injury to theperson being circumcised.

It is an object of the present invention, therefore, to provide noveland improved circumcision probe constructions by means of which thedisadvantages and drawbacks of the known probes and probing methods canbe efficaciously avoided.

More particularly, it is an object of the present invention to providenovel and improved circumcision probes the use of which in a novelprobing method will ensure that smegma accumulated in the cervix of theglans penis of a male person being circumcised will be loosened andbroken free without risk of injury to such person and will be at leastpartly removed when the probe is withdrawn from the prepuce.

Generally speaking, the objectives of the present invention are attainedby a circumcision probe construction characterized by a small, somewhatelongated, oval or round-tipped bulbous head which is undercut at oneside to provide a hook structure having a wall facing in the directionaway from the tip. The hook structure is preferably provided with asmall, medial, longitudinally extending channel starting slightlyrearwardly of the tip of the head and preferably deepening as well asflaring gradually in the direction away from the tip,

thereby imparting to the hook structure itself a dualearedconfiguration. In the use of the probe, upon insertion of the samebetween the glans penis and the mucosa, the hook structure is caused toenter the cervix of the glans where, as it is moved laterally back andforth, i.e., right and left around the glans and along the coronathereof, the ears of the hook structure will serve to loosen and freeaccumulated smegma to enable the same then to be drawn out with theprobe. In the novel probing method of the present invention, the extentof such movement of the probe toward the ventral portion of the glans islimited to a specified amount less than the full circumference of theglans to avoid any injury to the frenulum.

The foregoing and other objects, characteristics and advantages of thepresent invention will be more clearly understood from the followingdetailed description thereof when read in conjunction with theaccompanying drawing, in which:

FIG. 1 is a perspective view of a circumcision probe according to oneaspect of the present invention;

FIGS. la and 1b are, respectively, sectional views taken along the linesIla-1a and lib-1b in FIG. 1;

FIGS. 2 and 3 are, respectively, fragmentary side elevational and bottomplan views, on an enlarged scale, of the probe shown in FIG. 1;

FIGS. 4 and 5 are, respectively, fragmentary perspective views of theprobe of FIG. I in different stages of use thereof; and

FIG. 6 is a fragmentary bottom plan view, similar to FIG. 3, of acircumcision probe according to another aspect of the present invention.

Referring now to the drawing in greater detail, the probe 10 (FIG. 1)according to one aspect of the present invention has a body or handleportion 11, a neck portion 12 and a head 13. The body portion 11 ispreferably flat and bilaterally knurled or otherwise surfaceroughened,as shown at 11a (FIGS. 1 and 1a), in order to facilitate its beinggripped and held tightly without chance of slippage during a probingoperation. The body 11 is further provided with a dorsal depression 1 1bto accommodate the tip of the operator s index finger. The neck portion12 changes from flat to round configuration (FIG. lb) as it approachesthe head 13, and both the neck portion and the head are entirelysmooth-surfaced.

The head 13 is a relatively small, somewhat elongated, bulbous member ofgenerally oval configuration, for example about 1 to 2 mm. in diameterat its widest section and about 6 mm. or so long, which terminates in arounded or oval tip and is undercut at one side of the probe, as shownat 13b (FIGS. 2 and 4), to define a hook structure 130 about 1 to 2 mm.long as measured from the tip 13a and having a wall facing in thedirection away from the tip. The hook structure 130 is preferablyprovided with a small, medial, longitudinally extending, channel 14which starts slightly rearwardly of the tip 13a of the head and is shownas becoming gradually deeper and wider in the rearward direction (FIGS.2 and 3) until it intersects the said wall of the hook structure,although it will be apparent that the contours of the channel may differsomewhat from the illustrated shape, as by being straight-sided, ofconstant depth, etc. The channel provides the hook structure with a pairof lateral ears 113d, the manner of functioning of which will be morefully explained presently.

In use, the head end of the probe is inserted generally dorsally of theglans penis through preputial orifree 16 (FIG. 4), which may be heldsufficiently wide open with the aid of one or more small hemostats (notshown), and into the prepuce 17 so as to pass between the mucosaunderlying the same and the glans covered thereby, until the hookstructure 13c enters the cervix 18 of the glans just behind the corona19 thereof (FIG. 5). The probe is then gently moved back and fortharound the glans, i.e., to the right and left as indicated by the arrows20 and 21. The extent of such movement in the ventral direction must becarefully limited to terminate short of the ventral low point of theglans so as to avoid causing any damage to the frenulum 22. Inaccordance with my invention, the limits of the probe movementpreferably should be approximately the 4:30 and 7:30 oclock positions,the frenulum being considered as being at the 6:00 o clock position (theventral low point of the glans) and the dorsal high point of the glansas being at the 12:00 oclock position. During this movement, therefore,smegma which has accumulated in the cervix of the glans will be loosenedand broken free of the glans by the ears 13d of the hook structure 13 sothat, upon withdrawal of the probe, at least some of the smegma may bedrawn by the hook structure out of the cervix of the glans.concomitantly, the movement of the remainder of the head 13 of the probearound and over the corona of the glans, while the proximate section ofthe neck portion moves over the surface of the glans frontwardly of thecorona, will also loosen the mucosa therefrom, to enable the lattersubsequently to be cut off together with the prepuce, and will alsoloosen, for subsequent removal, any smegma lying on the surface of theglans forwardly of the corona.

Although the invention has so far been described with reference to aprobe constructioncharacterized by the provision of a channel in thehook structure, it is contemplated that the objectives of the presentinvention may also be attained by means of a probe construction lackingsuch a channel. This type of probe is represented in FIG. 6, where thehead 13, again undercut at 13b, is shown as having an imperforate hookstructure l3e the opposite corners 13f of which will serve as the earsof the hook structure and perform the function of loosening smegma inthe cervix of the glans as the probe is moved laterally back and forthabout the glans in the manner previously set forth.

Probes according to the present invention can be easily produced bystandard manufacturing techniques either to be reusable, in which casethey will preferably be made of stainless steel or the like, or to bedisposable after a single use, in which case for purposes of minimumcost of production they will preferably be made of syntheticthermoplastic or thermosetting resinous materials such as nylon,polyethylene, polypropylene, and the like suitably processed not only tohave the desired hardness or strength characteristics but also to beable to withstand autoclaving, for purposes of sterilization, attemperatures of about 300F. or more without softening or becomingwarped. Both the resinous or plastic material and any reinforcing fillerused therein must, of course, be non-toxic or characterized by levels oftoxicity sufficiently low to render them ac ceptable for surgicalprocedures on human beings.

It will be understood that the foregoing description of preferredembodiments of the present invention is for purposes of illustrationonly, and that the various structural and operational features hereindisclosed are susceptible to a number of modifications and changes noneof which entails any departure from the spirit and scope of the presentinvention as defined in the hereto appended claims.

Having thus described my invention, what i claim and desire to protectby Letters Patent is:

1. A circumcision probe for loosening smegma from the cervix of a glanspenis of an uncircumcised male human being, comprising a body portionadapted to be held by an operator, and a small, somewhat elongated,longitudinally extending generally oval, Mucosaloosening andsmegma-breaking head secured at one end to said body portion at one endof the latter, said head having a rounded tip and being undercut on oneside to define a corona engaging hook structure having a wall facingaway from said tip, said hook structure being adapted to be protractedinto and moved laterally along the cervix of a glans penis, with theportion of said head directed toward said body portion extending overthe corona of the glans and toward the orifice of the prepuce, uponinsertion of the probe through the orifice of the prepuce so as to passbetween the mucosa and the glans, whereby upon such movement of theprobe smegma accumulated in the cervix of the glans will be loosened andbroken free by said hook structure and may be at least partly extractedtherewith when the probe is withdrawn.

2. A circumcision probe according to claim 1, said hook structure beingprovided with a small, medial, longitudinally extending channel startingrearwardly of the tip of said head and intersecting said wall to providesaid hook structure with a pair of lateral ears.

3. A circumcision probe according to claim 2, said channel beingnarrowest at its end nearest the tip of said head and becoming graduallywider in the direction of said wall.

4. A circumcision probe according to claim 2, said channel beingshallowest at its end nearest the tip of said head and becominggradually deeper in the direction of said wall.

5. A circumcision probe according to claim 2, said channel beingshallowest and narrowest at its end nearest the tip of said head andbecoming gradually deeper and wider in the direction of said wall.

6. A circumcision probe according to claim 1, said head, said neckportion and said body portion constituting a one-piece structure made ofstainless steel.

7. A circumcision probe according to claim 1, said head, said neckportion and said body portion constituting a one-piece structure made ofsynthetic thermoplastic or thermosetting resinous materials, and havingzero or acceptably low levels of human toxicity and hardness or strengthcharacteristics sufficient to enable the entire structure to withstandautoclaving at temperatures of at least about 300F. without becomingsoftened or warped.

8. A method of probing the glans penis of a male person preliminary tothe performance of a circumcision operation on such person, comprisingthe steps of inserting through the orifice of the prepuce, generallydorsally of the glans and between the latter and the mucosa overlyingthe same, a probe which has a small, somewhat elongated, generally ovalbulbous head terminating in a rounded tip and is undercut on one side toprovide a hook structure having a wall facing away from said tip,advancing said probe inwardly over the glans until said hook structureenters the cervix of the glans behind the corona thereof, with theportion of said head farther from said tip than said hook structureextending over the corona and toward the orifice of the prepuce, movingsaid probe laterally right and left about the glans and toward theventral portion thereof to an extent terminating at either side of theglans somewhat short of the ventral low point of the glans constitutingthe location of the frenulum, thereby to move said hook structurecorrespondingly within the cervix of the glans and cause the mucosa tobe loosened from the surface of the glans and smegma accumulated in thecervix of the glans to be loosened and broken free therefrom, allwithout any potentially injurious contact between the probe and thefrenulum, and withdrawing said probe from the prepuce.

9. A method as claimed in claim 8, wherein the limits of the probemovement are approximately the 4:30 oclock position at one side of theglans and approximately the 7:30 oclock position at the other side ofthe glans, the location of the frenulum at the ventral low point of theglans being considered the 6:00 oclock position.

1. A circumcision probe for loosening smegma from the cervix of a glanspenis of an uncircumcised male human being, comprising a body portionadapted to be held by an operator, and a small, somewhat elongated,longitudinally extending generally oval, Mucosa-loosening andsmegma-breaking head secured at one end to said body portion at one endof the latter, said head having a rounded tip and being undercut on oneside to define a corona engaging hook structure having a wall facingaway from said tip, said hook structure being adapted to be protractedinto and moved laterally along the cervix of a glans penis, with theportion of said head directed toward said body portion extending overthe corona of the glans and toward the orifice of the prepuce, uponinsertion of the probe through the orifice of the prepuce so as to passbetween the mucosa and the glans, whereby upon such movement of theprobe smegma accumulated in the cervix of the glans will be loosened andbroken free by said hook structure and may be at least partly extractedtherewith when the probe is withdrawn.
 2. A circumcision probe accordingto claim 1, said hook structure being provided with a small, medial,longitudinally extending channel starting rearwardly of the tip of saidhead and intersecting said wall to provide said hook structure with apair of lateral ears.
 3. A circumcision probe according to claim 2, saidchannel being narrowest at its end nearest the tip of said head andbecoming gradually wider in the direction of said wall.
 4. Acircumcision probe according to claim 2, said channel being shallowestat its end nearest the tip of said head and becoming gradually deeper inthe direction of said wall.
 5. A circumcision probe according to claim2, said channel being shallowest and narrowest at its end nearest thetip of said head and becoming gradually deeper and wider in thedirection of said wall.
 6. A circumcision probe according to claim 1,said head, said neck portion and said body portion constituting aone-piece structure made of stainless steel.
 7. A circumcision probeaccording to claim 1, said head, said neck portion and said body portionconstituting a one-piece structure made of synthetic thermoplastic orthermosetting resinous materials, and having zero or acceptably lowlevels of human toxicity and hardness or strength characteristicssufficient to enable the entire structure to withstand autoclaving attemperatures of at least about 300*F. without becoming softened orwarped.
 8. A method of probing the glans penis of a male personpreliminary to the performance of a circumcision operation on suchperson, comprising the steps of inserting through the orifice of theprepuce, generally dorsally of the glans and between the latter and themucosa overlying the same, a probe which has a small, somewhatelongated, generally oval bulbous head terminating in a rounded tip andis undercut on one side to provide a hook structure having a wall facingaway from said tip, advancing said probe inwardly over the glans untilsaid hook structure enters the cervix of the glans behind the coronathereof, with the portion of said head farther from said tip than saidhook structure extending over the corona and toward the orifIce of theprepuce, moving said probe laterally right and left about the glans andtoward the ventral portion thereof to an extent terminating at eitherside of the glans somewhat short of the ventral low point of the glansconstituting the location of the frenulum, thereby to move said hookstructure correspondingly within the cervix of the glans and cause themucosa to be loosened from the surface of the glans and smegmaaccumulated in the cervix of the glans to be loosened and broken freetherefrom, all without any potentially injurious contact between theprobe and the frenulum, and withdrawing said probe from the prepuce. 9.A method as claimed in claim 8, wherein the limits of the probe movementare approximately the 4:30 o''clock position at one side of the glansand approximately the 7:30 o''clock position at the other side of theglans, the location of the frenulum at the ventral low point of theglans being considered the 6:00 o''clock position.